“Are generic drugs just as safe and effective?” This question is raised by most parents since out of pocket costs are almost always higher for brand-name medications. In addition, most doctors are required by insurance carriers to substitute a generic product for a brand-name product. Most parents prefer a generic medication due to the added cost of a brand-name drug. Generally, this substitution is both safe and reasonable. There are a few situations, however, when generic substitutions can cause adverse health effects. A few medications have a narrow therapeutic index (NTI) and substitution of a generic drug for a brand-name drug can cause a change in the blood level of the drug which can cause a worsening of a medical condition or new medical problems. This can be seen in medication used to treat depression, anxiety, seizures and for medications used for blood thinning or contraception. Specific drugs in this category include levothyroxine, warfarin, phenytoin and digoxin.
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